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比较和评价三种不同培养基在模拟血培养中对临床常用抗菌药物的中和作用。

Comparison and evaluation of neutralization of clinically frequently used antimicrobial agents using three different culture media in simulated blood cultures.

机构信息

Jiangxi Province Key Laboratory of Immunology and Inflammation, Jiangxi Provincial Clinical Research Center for Laboratory Medicine, Department of Clinical Laboratory, The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.

Intravenous Medication Dispensing Center, The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.

出版信息

Microbiol Spectr. 2024 Oct 3;12(10):e0097924. doi: 10.1128/spectrum.00979-24. Epub 2024 Aug 27.

Abstract

UNLABELLED

The performance of BACT/ALERT FA/FN Plus (France) blood culture containing a novel resin, DL (China) blood culture containing common resin, and adsorbent-free REDOX (USA) blood culture relying on dilution for antimicrobial neutralization at %peak serum concentration was evaluated by measuring the recovery of organisms and time to detection (TTD) in nine simulated microorganism-antimicrobial combination blood cultures. Significant differences were observed in the recovery rates among the aerobic media: 87.5% for BACT/ALERT media, 42.9% for DL media, and 12.5% for REDOX media. In contrast, no statistical difference was found in the TTD between FA Plus media and DL aerobic media. For the anaerobic media, the recovery rates were 91.4% for BACT/ALERT media, 2.9% for DL media, and 14.3% for REDOX media, with significant differences only between BACT/ALERT FN Plus media and the others. Among the seven main antimicrobial categories, only BACT/ALERT FA/FN Plus culture media demonstrated high recovery of microorganisms, with the exception of carbapenems. The DL culture media exhibited a relatively high recovery rate of microorganisms in the presence of piperacillin/tazobactam, levofloxacin, and gentamicin, but only in aerobic conditions. Conversely, REDOX media displayed microorganism recovery solely in the presence of gentamicin. BACT/ALERT FA/FN Plus culture media with novel resin showed absolute advantages over DL and REDOX culture media and can, therefore, be selectively applied in clinical settings when antimicrobials are used prior to blood collection. DL culture media, containing common resin, outperformed adsorbent-free dilution-based REDOX culture media, making it a viable backup option. There is a need to focus on improving the neutralization of carbapenems with current inefficiency in all three medias.

IMPORTANCE

We present a study on performance comparison of three different commercial culture media for neutralization of antibiotic effects in simulated blood cultures. BACT/ALERT (FA Plus and FN Plus) culture media with novel resin showed absolute advantages over DL and REDOX culture media at %PSL concentration of antimicrobials.

摘要

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本研究通过在 9 种模拟微生物-抗菌组合血培养物中检测微生物回收率和检测时间(TTD),评估了含有新型树脂的 BACT/ALERT FA/FN Plus(法国)血培养瓶、含有普通树脂的 DL(中国)血培养瓶和依靠稀释来对抗菌剂进行中和的无吸附剂 REDOX(美国)血培养瓶的性能。在需氧培养基中观察到回收率有显著差异:BACT/ALERT 培养基为 87.5%,DL 培养基为 42.9%,REDOX 培养基为 12.5%。相比之下,FA Plus 培养基与 DL 需氧培养基的 TTD 无统计学差异。对于厌氧培养基,BACT/ALERT 培养基的回收率为 91.4%,DL 培养基为 2.9%,REDOX 培养基为 14.3%,仅 BACT/ALERT FN Plus 培养基与其他培养基之间有显著差异。在 7 个主要抗菌类别中,只有 BACT/ALERT FA/FN Plus 培养基显示出微生物的高回收率,碳青霉烯类除外。DL 培养基在哌拉西林/他唑巴坦、左氧氟沙星和庆大霉素存在的情况下显示出相对较高的微生物回收率,但仅在需氧条件下。相反,REDOX 培养基仅在庆大霉素存在的情况下显示出微生物的回收率。含有新型树脂的 BACT/ALERT FA/FN Plus 培养基与 DL 和 REDOX 培养基相比具有绝对优势,因此,在采集血液前使用抗生素时,可以有选择地将其应用于临床环境中。DL 培养基含有普通树脂,优于无吸附剂的基于稀释的 REDOX 培养基,是一种可行的备用选择。需要关注的是,如何提高所有三种培养基对抗菌剂的中和效率,尤其是对碳青霉烯类。

重要性

本研究对三种不同商业血培养瓶在模拟血培养中对抗生素作用中和效果的性能进行了比较。BACT/ALERT(FA Plus 和 FN Plus)培养基在抗菌剂浓度为 %PSL 时,与 DL 和 REDOX 培养基相比具有绝对优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bb4/11448418/4c9700c5ed9c/spectrum.00979-24.f001.jpg

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